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Published on: January 5, 2015
A child who recovered completely after spinal cord injury complicated by C2-3 fracture dislocation: case report
Kenshi Sakayama1, Teruki Kidani, Yoshiro Matsuda
1Department of Orthopedic Surgery, Ehime University School of Medicine, Ehime, Japan. kenshi@m.ehime-u.ac.jp
Insights
A rare case of pediatric spinal cord injury due to C2-C3 fracture dislocation shows complete recovery after surgery. This highlights the potential for significant neurological recovery in children with severe spinal trauma.
Area of Science:
- Pediatric neurosurgery
- Spinal cord injury research
- Trauma surgery
Background:
- Spinal cord injury (SCI) complicated by C2-C3 fracture dislocation in children is rare.
- Complete recovery after surgical intervention for such injuries is exceptionally uncommon.
- Long-term follow-up imaging (MRI, MRA) data for these cases are scarce.
Observation:
- A 4-year-old girl sustained a C2-C3 fracture dislocation with Frankel B spinal cord injury from a traffic accident.
- Surgical intervention involved C2-C3 fixation using interlaminal wiring in a prone position.
- The patient experienced an excellent postoperative course with complete neurological recovery.
Findings:
- Postoperative MRI at 5 years showed no spinal cord abnormalities.
- Vertebral artery patency was confirmed by magnetic resonance angiography 5 years post-surgery.
- The patient achieved complete recovery from Frankel B spinal cord injury.
Implications:
- This case demonstrates the possibility of substantial recovery in pediatric spinal cord injuries, even with severe initial presentation.
- Effective systemic management of complex, multi-organ injuries is crucial for favorable outcomes.
- Highlights the importance of surgical intervention and long-term follow-up in managing pediatric C2-C3 fracture dislocations.
Study Design:
This was a case of a child who recovered completely after spinal cord surgery complicated by C2-C3 fracture dislocation.
Objectives:
To clarify the important issue with regard to the diagnosis and treatment of possible spinal cord injury complicated by C2-C3 fracture dislocation in children.
Summary Of Background Data:
Reports on spinal cord injury complicated by C2-C3 fracture dislocation in children who recovered completely after surgery are very rare. Moreover, there are no reports of cases in which described MRI and magnetic resonance angiography obtained 5 years after surgery.
Methods:
A 4-year-old girl with complete fracture dislocation of C2-C3 and spinal cord injury of Frankel B because of a traffic injury. A middle incision was made in a prone position under general anesthesia, and C2-C3 was fixed with interlaminal wiring according to the McGraw modified method.
Results:
The postoperative course was excellent, and the patient recovered completely. An MRI performed 5 years after surgery revealed no definitive abnormality in spinal cord and patency of vertebral arteries.
Conclusion:
This was a very rare case of spinal cord injury complicated C2-C3 fracture dislocation in children. The present case is of interest in that it demonstrated the possibility of recovery in a child from spinal cord injuries of Frankel B immediately after injury, if complex injuries in multiple organs are controlled by systemic management.
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